Low-intensity extracorporeal shockwave therapy for erectile dysfunction: An update / 中华男科学杂志

Low-intensity extracorporeal shockwave therapy (LI-ESWT) is a novel treatment for erectile dysfunction (ED). With the property of angiogenesis, LI-ESWT acts on vasculogenic ED by improving penile hemodynamics and endothelial function. LI-ESWT is proved to be safe and effective in the treatment of vasculogenic ED in various prospective clinical studies, including randomized, double-blind, and sham-controlled trails. With more multi-centered larger-sample randomized controlled trials, LI-ESWT will play a valuable role in the treatment of ED.

Minimally invasive techniques in the treatment of benign prostatic hyperplasia: An update / 中华男科学杂志

Lower urinary tract symptoms (LUTS) resulting from benign prostatic hyperplasia (BPH) obviously impair the quality of life of middle-aged and elderly men. Current management of BPH includes wait-and-watch, medical therapy, and conventional surgery. As a new approach, minimally invasive surgery has been playing an increasingly important role in the management of BPH, with potential advantages of less operative trauma, quicker recovery, lower risk of postoperative complications and higher quality of life. This review mainly discusses prostatic urethral lift (Urolift® System), transurethral water vapor therapy (Rezūm® System) and robot-guided high-energy water ablation (PROCEPT Aquablation™ System).

Prostatic urethral lift: A novel minimally invasive treatment for benign prostatic hyperplasia / 中华男科学杂志

Benign prostatic hyperplasia (BPH) and BPH-induced lower urinary tract symptoms (LUTS) are common factors influencing the quality of life (QOL) of elderly males. In case of undesirable or adverse effects of medication, many BPH patients seek surgical treatment. Transurethral resection of the prostate (TURP), though evidently effective for BPH, fails to preserve the sexual function and therefore reduces the QOL of the patients. Moreover, some elderly patients with comorbidities may be unfit for TURP. Prostatic urethral lift (PUL) is a newly developed surgical procedure for the treatment of LUTS secondary to BPH. With the advantages of minimal invasiveness, low rate of peri- and post-operative complications, and maximal preservation of patients' erectile and ejaculatory functions, PUL is winning more and more attention from the clinicians and patients.

Pro-prostate-specific antigen and its related indexes in the diagnosis of prostate cancer / 中华男科学杂志

Pro-prostate-specific antigen (proPSA) is the precursor of PSA and a form of free PSA (fPSA). In recent years, a lot of studies have been done on proPSA, the roles of its related indexes in the diagnosis of prostate cancer, and the value of its clinical application. The correlated indexes of proPSA include proPSA, % pPSA, p2PSA, % p2PSA and prostate health index (PHI). They are more effective than total PSA (tPSA) and fPSA in the diagnosis of prostate cancer, especially % p2PSA and PHI, which may significantly increase our ability to detect and identify PCa and lower the rate of unnecessary biopsies. This article presents an overview on the advances in the studies of proPSA and the application of its related indexes in the diagnosis of prostate cancer.

Application of traction therapy for Peyronie's disease: present and prospect / 中华男科学杂志

Peyronie's disease is an acquired connective tissue disorder affecting the tunica albuginea of the corpus cavernosum, causing penile plaque formation and persistent scar. It typically affects males between the ages of 45 and 60 years. The exact cause of Peyronie's disease is not clear and its pathological and physiological performance is the local deposition of fibrin and collagen. Men afflicted by this disorder may present with erectile pain, penile deformity (such as penile curvature or penile shortening), psychological disorder and/or erectile dysfunction. Though many medical and surgical options have been developed for the treatment of Peyronie's disease and each has its own indications, advantages and disadvantages, none of them produces very desirable effect. The studies of traction therapy for Peyronie's disease have been gradually increased in recent years. Traction therapy can be employed as a solo therapy or a part of combination therapy, preoperative or postoperative therapy for Peyronie's disease. Recent researches show that traction therapy can prevent the progression of scar, restore the length and diameter of a short penis, reduce the curvature of the penis and improve sexual function. However, large sample, multi-center, randomized controlled studies are needed to confirm its validity for Peyronie's disease. In addition, more endeavors should be exerted at its pathogenesis in order to achieve effective prevention and cure of the disease.

From pro-prostate specific antigen, -2pro-prostate specific antigen to Beckman Coulter phi: the evolution of new biomarkers for early detection of prostatic carcinoma / 中华医学杂志(英文版)

Prostate specific antigen (PSA) has a wide clinical use for the early detection of prostatic carcinoma (PCa); however, it has never been a perfect marker due to its low specificity and low positive predictive value which ranges between 4 ng/ml and 10 ng/ml. The discovery of different PSA molecular forms in serum in the early 1990s brought insight into searching for more specific markers. Since then free PSA (fPSA) has been used routinely to increase the specificity for PCa and to reduce unnecessary biopsies. More recently, promising data is emerging regarding one proenzyme molecular form of free PSA, proPSA, and a few truncated proPSA isoforms. The purpose of this article is to review the recent studies on clinical utility of proPSA, especially [−2]pPSA, an isoform of proPSA, and parameters involving [−2]pPSA as well as other PSA derivatives in early detection of PCa.

Application of extracorporeal shockwave therapy in andrology / 中华男科学杂志

Extracorporeal shockwave therapy (ESWT) has been widely used in various fields ever since it was first introduced for the treatment of urinary stones in 1983. Recent years see a growing application of ESWT to andrology. Studies show that ESWT can relieve pain in 83% of the patients with Peyronie's disease, and has won favorable comments from 66% of the patients. ESWT can significantly improve the sexual life quality of the patients with organic erectile dysfunction, yields good effect in the treatment of chronic nonbacterial prostatitis, especially in pain relief. ESWT has offered new ideas and options for the treatment of andrological diseases. However, its mechanisms have yet to be clarified by more in-depth basic studies and multi-centered, large-sample randomized controlled trials.

Efficacy and safety of selective serotonin re-uptake inhibitors in the treatment of premature ejaculation: a systematic evaluation / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of selective serotonin re-uptake inhibitors (SSRIs) in the treatment of premature ejaculation (PE).</p><p><b>METHODS</b>From MEDLINE (Jan, 1950-Mar, 2008), EMBASE (Jan, 1980-Mar, 2008), The Cochrane Library (Issue 1, 2008) and CNKI (Jan, 1979-Mar, 2008), we retrieved and screened the randomized controlled trials (RCT) and randomized crossover trials (RT) as well as various related data, published and unpublished, on the treatment of PE with SSRIs. The methodological quality of the included trials was evaluated by 2 reviewers. Meta-analyses were conducted with RevMan 5.0 on the homogeneous studies.</p><p><b>RESULTS</b>Totally 22 studies on 4 291 patients were included. Meta-analyses showed that after treated with sertraline, fluoxetine, paroxetine, citalopram, dapoxetine and fluvoxamine, the WMD (95% CI) values of the changes in intravaginal ejaculatory latency time (IELT) were 2.63 (1.80, 3.46), 2.21 (1.50, 2.92), 4.31 (2.71, 5.91), 3.82 (3.39, 4.25), 1.57 (1.31, 1.84) and 0.01 (0.71, 0.73) respectively; the RR (95% CI) values of the sexual satisfaction rate of the patients were 1.65 (1.12, 2.43), 2.93 (0.50, 17.31), 3.08 (2.27, 4.17), 2.48 (1.99, 3.09) and 2.93 (2.36, 3.65), and those of their partners were 1.47 (0.98, 2.21), 2.88 (0.38, 21.77), 4.81 (3.15, 7.36), 5.38 (3.75, 7.72) and 2.91 (1.09, 7.78) respectively for sertraline, fluoxetine, paroxetine, citalopram and dapoxetine.</p><p><b>CONCLUSION</b>All the known SSRIs but fluvoxamine could prolong IELT, and some could improve the sexual satisfaction of both the patients and their partners, but their adverse effects should be noted. The moderate possibility of selection bias and publication bias in the included studies might have a negative impact on the evidence intensity of our results. We expect more reliable evidence from more randomized controlled trials.</p>

Expression of CD117 in human testicular germ cell tumors and its diagnostic value for seminoma and nonseminoma / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the expression of CD117 in human testicular germ cell tumors and its value in the differential diagnosis of seminoma and nonseminoma.</p><p><b>METHODS</b>Seventy-four human testicular germ cell tumor specimens were studied by ABC kit immunohistochemical staining detection using CD117 monoclonal antibodies. The immunoreaction scores (IRS) of all the specimens were calculated and analysed for their clinical significance.</p><p><b>RESULTS</b>Among the 74 germ cell tumors, 31 out of 32 (9 6.9%) seminomas showed positive staining of the CD117 mostly on the cell membrane. Four of 31 (12.9%) nonseminomas displayed a weak positive staining of CD117 only in the cytoplasm of a few cells. In 10 of 11 mixed germ cell tumors, a relatively weak expression of CD117 was shown only in the seminoma component. The CD117 expression was diagnostically decreased from seminoma to mixed seminoma and to nonseminoma successively, with IRS of 6.82 +/- 2.76, 1.25 +/- 0.42 and 0.60 +/- 0.16, respectively. There was a significant difference in the CD117 expression between seminoma and nonseminoma (P < 0.05). CD 117 proteins were positively expressed in all the 20 specimens of the normal testis.</p><p><b>CONCLUSION</b>The detection of CD117 by immunohistochemical staining using CD117 monoclonal antibodies is a newly developed useful method for differentiating seminoma and nonseminoma.</p>

The clinical treatment analysis of 176 cases of testicular germ cell tumor / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the diagnosis, treatment and prognosis of testicular germ cell tumor.</p><p><b>METHODS</b>From Oct. 1980 to Oct. 2000, 176 cases with testicular germ cell tumor treated in West China Hospital of Sichuan University were reported, and the clinical manifestations, diagnosis and treatment were analyzed retrospectively.</p><p><b>RESULTS</b>There were 111 cases of testicular seminoma, 43 cases of testicular non-seminoma and 22 cases of mixture testicular germ cell tumor, and 46 out of 176 cases were complicated with cryptorchidism. The prognosis of patients was related to clinical stages, treatment and cryptorchidism.</p><p><b>CONCLUSION</b>Since there is no significant difference in the oncological control effects in Stage I testicular seminoma, radiotherapy is not necessary after radical orchiectomy to avoid the side effects of radiation. The treatment of testicular non-seminoma, testicular seminoma in the stage II and III should combine the radical orchiectomy and radiotherapy. Early diagnosis and early treatment are the two most important factors affecting the survival of patients with testicular germ cell tumor.</p>

Effect of KLF6 on prostate cancer cell line PC-3 by transgenic method / 中华男科学杂志

<p><b>OBJECTIVE</b>To observe the effect of KLF6 on prostate cancer cell line PC-3 by transgenic method.</p><p><b>METHODS</b>We obtained KLF6 cDNA by RT-PCR method from the liver cell, transfected plasmid pEGFP-C, recombinated with KLF6 into PC-3 cells, and used them as a transfection group and a control group. MTT, flow cytometer and immunocytochemical methods were used to observe the effect of anti-oncogene wild type KLF6 on prostate cancer cell line PC-3 by transgenic method for 48 hours.</p><p><b>RESULTS</b>After transfected into PC-3 cells, KLF6 enhanced growth suppression, (30.0 +/- 5.4)% in the transfection group and 0% in the control, P < 0.01, apoptosis, (24.3 +/- 2.3)% in the transfection group and (5.2 +/- 0.7)% in the control, P < 0.01, the down-regulation of the expression of cyclin D1, (25.3 +/- 3.7)% in the transfection group and (38.5 +/- 4.6)% in the control, P < 0.05 and Bcl-2, (18.7 +/- 3.2)% in the transfection group, and (41.8 +/- 5.9)% in the control, P < 0.01 in PC-3 cells. It also decreased the ratio of the cell phase G2/M, increased the ratio of G0/G1 from (58.6 +/- 7.3)% in the control to (80.0 +/- 9.8)% in the transfection group, P < 0.05.</p><p><b>CONCLUSION</b>PC-3 cells transfected with wild type KLF6 can enhance its growth suppression and apoptosis. It shows great potential for the gene therapy of androgen-independent carcinoma of the prostate.</p>

Effects of heating on the epithelia of benign prostate hyperplasia in vitro / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the biological changes of the epithelia of benign prostate hyperplasia under heating at different temperatures and at different points of time after heating.</p><p><b>METHODS</b>Cell morphology, MTT, flow cytometer, and the immunocytochemical method for detecting heat shock protein 70 and prostate specific antigen were used to observe the effect of heating on the primarily cultured epithelia of benign prostate hyperplasia at 45 degrees C and 60 degrees C and at 1 hour and 12 hours after heating.</p><p><b>RESULTS</b>Heating at 45 degrees C for 15 min resulted in apoptosis, and at 60 degrees C, necrosis in most of the cells. The inhibiting effect of heating on the growth of cells was observed, more significant in the 60 degrees C group than in the 45 degrees C group. The cell phase arrest induced by heat, mainly G0/G1 arrest, was more significant in the 12 h group than in the 1 h group. Heating up-regulated the expressions of heat shock protein 70 and prostate specific antigen in cells.</p><p><b>CONCLUSION</b>Heating can induce apoptosis, necrosis and growth suppression of the epithelia of benign prostate hyperplasia. Its process and mechanism are correlated with the cell phase arrest and the up-regulation of the expressions of heat shock protein 70 and prostate specific antigen.</p>

Clinical study on application of bailing capsule after renal transplantation / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe and assess the immunosuppressive effect of applying bailing capsule (BLC, a dry powder preparation of Cordyceps sinensis mycelia), after renal transplantation, its influence on other systems of organism, and to explore the possible therapeutic mechanism.</p><p><b>METHODS</b>One hundred and twenty-one recipients of renal homo-allograft were randomly divided into two groups. The 64 cases in Group A was treated with cyclosporin A (Cs A) + prednisone (pred) + azathioprine (Aza), the 57 in Group B treated with Cs A + pred + BLC. They were followed-up for 1-2 year by checking up blood routine, urine routine, liver and renal function, blood electrolytes, glucose and lipids, and uric acid for 2 times every week in the first month after transplantation, followed by proper re-examination of these items according to various condition.</p><p><b>RESULTS</b>There was no significant difference between the two groups in aspects of graft survival rate, occurrence of reject reaction, renal function recovery, blood electrolytes and blood glucose levels. However, as compared with Group A, in Group B, levels of urinary erythrocytes and leucocytes, blood alanine transaminase (ALT), aspartate aminotransferase (AST), total cholesterol, uric acid as well as the incidence of infection were significantly lower, and blood high density lipoprotein, serum total protein, albumin, RBC and WBC count were significantly higher.</p><p><b>CONCLUSION</b>BLC could effectively prevent the reject response after renal transplantation, protect renal and liver function, stimulate hemopoietic function, improve hypoproteinemia and hyperlipidemia, reduce the infection, etc., therefore, it is an ideal immunosuppressor after organ transplantation.</p>